TY 2017 Form 990

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
SchDMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

NATIONAL ALLIED WORKERS UNION INSURANCE
TRUST FUND

Employer identification number

36-2241970

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under FASB ASC 958, to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2019

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....

Part V

Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a) Current year	(b) Prior year	(c) Two years back	(d) Three years back	(e) Four years back

1a	Beginning of year balance ....
b	Contributions ...
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Term endowment SchDMd Bullet

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) Unrelated organizations .................

3a(i)

(ii) Related organizations .................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....
b	Buildings ....
c	Leasehold improvements
d	Equipment ....
e	Other .....
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..		0

Schedule D (Form 990) 2019

Page 3

Part VII

InvestmentsOther Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3)Other
(B)
(C)
(D)
(E)
(F)
(G)
(H)
(I)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	9,869
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2019

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......		1	22,734,605
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e	0
3	Subtract line 2e from line 1..................		3	22,734,605
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................		4c	0
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5	22,734,605

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1	21,877,265
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d....................		2e	0
3	Subtract line 2e from line 1...................		3	21,877,265
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................		4c	0
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5	21,877,265

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference	Explanation
PART X, LINE 2:	ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE THE BOARD OF TRUSTEES TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF THE ORGANIZATION HAS TAKEN AN UNCERTAIN TAX POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE BOARD OF TRUSTEES HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN, AND HAS CONCLUDED THAT AS OF MARCH 31, 2018, THERE ARE NO UNCERTAIN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE BOARD OF TRUSTEES BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO APRIL 1, 2015.

Return Reference

Explanation

PART X, LINE 2:

ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE THE BOARD OF TRUSTEES TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF THE ORGANIZATION HAS TAKEN AN UNCERTAIN TAX POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE BOARD OF TRUSTEES HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN, AND HAS CONCLUDED THAT AS OF MARCH 31, 2018, THERE ARE NO UNCERTAIN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE BOARD OF TRUSTEES BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO APRIL 1, 2015.

Schedule D (Form 990) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

NATIONAL ALLIED WORKERS UNION INSURANCE
TRUST FUND

Employer identification number

36-2241970

Return Reference	Explanation
FORM 990, PART VI, SECTION A, LINE 1	THE FORM 990 WAS PREPARED BY MACNELL ACCOUNTING & CONSULTING, LLP AND PROVIDED TO THE ADMINISTRATOR, WILLIAM EINHORN, OF THE PLAN. THE ADMINISTRATOR, WILLIAM EINHORN, HAS BEEN GIVEN THE AUTHORITY BY THE BOARD OF TRUSTEES TO REVIEW THE FORM 990 PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. SUBSEQUENTLY A COPY OF THE FORM IS PROVIDED TO THE ENTIRE BOARD AT A TRUSTEE MEETING.
FORM 990, PART VI, SECTION A, LINE 3	THE PLAN DELEGATED CONTROL OVER DAY TO DAY MANAGEMENT DUTIES TO AEGIS ADMINISTRATIVE SERVICES, A THIRD PARTY ADMINISTRATOR
FORM 990, PART VI, SECTION B, LINE 11B	THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM AND PROVIDED TO THE ADMINISTRATOR, WILLIAM EINHORN, OF THE PLAN. THE ADMINISTRATOR, WILLIAM EINHORN, HAS BEEN GIVEN THE AUTHORITY BY THE BOARD OF TRUSTEES TO REVIEW THE FORM 990 PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. SUBSEQUENTLY A COPY OF THE FORM IS PROVIDED TO THE ENTIRE BOARD AT THE TRUSTEE MEETING.
FORM 990, PART VI, SECTION C, LINE 19	THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

NATIONAL ALLIED WORKERS UNION INSURANCE
TRUST FUND

Employer identification number

36-2241970

Part I

Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

Identification of Related Tax-Exempt Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)NATIONAL ALLIED WORKERS UNION LOCAL 831 1107 S MANNHEIM ROAD WESTCHESTER,IL60154 36-4159396	LOCAL UNION	IL	501(C)(5)				No
(2)NATIONAL ALLIED WORKERS UNION LOCAL 831 SAVINGS AND RETIREMENT PLAN 6970 WEST DIVERSEY AVENUE CHICAGO,IL60707 90-0724512	SAVINGS AND RETIREMENT PLAN	IL	501(C)(18)				No

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2019

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) GF55 PARTNERS 19 W 21ST STREET NEW YORK,NY10010	CONTRIBUTING EMPLOYERS						No			No
(2) LOFARO & REISER LLP 20 COURT STREET HACKENSACK,NJ07601	CONTRIBUTING EMPLOYERS						No			No
(3) OFECK AND HEINZE LLP 85 MAIN STREET SUITE 204 HACKENSACK,NJ07601	CONTRIBUTING EMPLOYERS						No			No
(4) PENACHIO MALARA LAW FIRM 235 MAIN STREET 610A WHITE PLAINS,NY10601	CONTRIBUTING EMPLOYERS						No			No
(5) SILVERPOINT CAPITAL LP TWO GREENWICH PLAZA FIRST FLOOR GREENWICH,CT06830	CONTRIBUTING EMPLOYERS						No			No
(6) AD ADVERTISE DESIGNS LLC 10 HICKORY ROAD HIGHLAND LAKES,NJ07422	CONTRIBUTING EMPLOYERS						No			No
(7) CANOPY MEDICAL LLC 1160 VIERLING DR SHAKOPEE,MN55379	CONTRIBUTING EMPLOYERS						No			No
(8) LARSON & PAUL ARCHITECTS LLP 501 FIFTH AVENUE STE 2108 NEW YORK,NY10017	CONTRIBUTING EMPLOYERS						No			No

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	Yes	No
(1) AARON BAIL BONDS CORP 312 BALDWIN AVE JERSEY CITY,NJ07306	CONTRIBUTING EMPLOYERS							No
(2) ACME 9 GREAT JONES STREET NEW YORK,NY10012	CONTRIBUTING EMPLOYERS							No
(3) ACUMEN DIRECT INC 8 SPRINGWOOD LN HUNTINGTON,NY11743	CONTRIBUTING EMPLOYERS							No
(4) ADVANCED MEDICAL GROUP 4604 31ST AVE ASTORIA,NY11103	CONTRIBUTING EMPLOYERS							No
(5) AGRO'S LANDSCAPING INC 9 LINDEN PLACE TARRYTOWN,NY10591	CONTRIBUTING EMPLOYERS							No
(6) ALA USA UNAVAILABLE NEW YORK,NY00000	CONTRIBUTING EMPLOYERS							No
(7) ALL AMERICAN STAIRS & RAILINGS INC 130-23 91ST AVE RICHMOND HILL,NY11418	CONTRIBUTING EMPLOYERS							No
(8) ANEDOM LLC PO BOX 212 HARRISON,NY10528	CONTRIBUTING EMPLOYERS							No
(9) AREXA RURIK EKSTROM & ASSOC LLC 25 BROADWAY NEW YORK,NY10004	CONTRIBUTING EMPLOYERS							No
(10) BAMS HOLDING GROUP LLC 413 86TH STREET 2 BROOKLYN,NY11209	CONTRIBUTING EMPLOYERS							No
(11) CLUB PET NYC 76 DIKEMAN STREET BROOKLYN,NY11231	CONTRIBUTING EMPLOYERS							No
(12) CONCURRENT INDUSTRIES GROUP 1 E 66TH STREET NEW YORK,NY10065	CONTRIBUTING EMPLOYERS							No
(13) D&D PERIODONTAL ASSOCIATES 57 W 57TH STREET 605 NEW YORK,NY10019	CONTRIBUTING EMPLOYERS							No
(14) DAVE'S TRANSMISSION 481 QUINCY AVE QUINCY,MA02169	CONTRIBUTING EMPLOYERS							No
(15) ELECTRICAL SERVICES LLC UNAVAILABLE NEW YORK,NY00000	CONTRIBUTING EMPLOYERS							No
(16) ELEGRAN LLC 353 LEXINGTON AVE NEW YORK,NY10016	CONTRIBUTING EMPLOYERS							No
(17) ENGLEWOOD FLORIST INC 47 E PALISADE AVE ENGLEWOOD,NJ07631	CONTRIBUTING EMPLOYERS							No
(18) EVANS & LEWIS UNAVAILABLE CONNECTICUT,CT00000	CONTRIBUTING EMPLOYERS							No
(19) FREYER COLLABORATIVE ARCHITECTS 37 E 18TH STREET 1001 NEW YORK,NY10003	CONTRIBUTING EMPLOYERS							No
(20) HEALTH DEPOT ASSOCIATION 11 CATHERINE PLACE KATONAH,NY10536	CONTRIBUTING EMPLOYERS							No
(21) IDEAL HEATING COMPANY 9515 SOUTHVIEW AVE BROOKFIELD,IL60513	CONTRIBUTING EMPLOYERS							No
(22) INTEGRATED REPORTING IS SIMPLE LLC 413 86TH STREET BROOKLYN,NY11209	CONTRIBUTING EMPLOYERS							No
(23) INTERNATIONAL COACHES FEDERATION 11 CATHERINE PLACE KATONAH,NY10536	CONTRIBUTING EMPLOYERS							No
(24) ISLAND RUBBER OF NY WANTAGH WANTAGH,NY11793	CONTRIBUTING EMPLOYERS							No
(25) JOHN GILCHRIST & SONS INC 260 LAKE STREET OAK PARK,IL60302	CONTRIBUTING EMPLOYERS							No
(26) KATZ ARCHITECTURE 150 W 22ND STREET NEW YORK,NY10011	CONTRIBUTING EMPLOYERS							No
(27) KIDS CANT MISS UNAVAILABLE NEW JERSEY,NJ00000	CONTRIBUTING EMPLOYERS							No
(28) KOKO ARCHITECTURE & DESIGN 38 DELANCEY STREET NEW YORK,NY10002	CONTRIBUTING EMPLOYERS							No
(29) LEONG LEONG LLC 167 BOWERY 3 NEW YORK,NY10002	CONTRIBUTING EMPLOYERS							No
(30) LOVING HANDS HOME HEALTH CARE SERVICES LLC 676 WINTERS AVENUE PARAMUS,NJ07652	CONTRIBUTING EMPLOYERS							No
(31) LYDON HEATING & PLUMBING 31 SUNNYSIDE LN BRAINTREE,MA02184	CONTRIBUTING EMPLOYERS							No
(32) MATTHEW BAIRD ARCHITECTS 2ND FLOOR 289 HUDSON STREET NEW YORK,NY10013	CONTRIBUTING EMPLOYERS							No
(33) MSA APPAREL LLC 1410 BROADWAY 703 NEW YORK,NY10018	CONTRIBUTING EMPLOYERS							No
(34) NATIONAL CELLULAR USA 5620 1ST AVE 3 BROOKLYN,NY11220	CONTRIBUTING EMPLOYERS							No
(35) NESCONSET DENTAL 239 SMITHTOWN BLVD NESCONSET,NY11767	CONTRIBUTING EMPLOYERS							No
(36) QC ENTERPRISES 2722 S HILLOCK AVENUE CHICAGO,IL60608	CONTRIBUTING EMPLOYERS							No
(37) PREMIER DENTAL NETWORK 6970 W DIVERSEY AVE CHICAGO,IL60707	CONTRIBUTING EMPLOYERS							No
(38) PREVIEW TEXTILE GROUP 225 W 37TH STREET NEW YORK,NY10018	CONTRIBUTING EMPLOYERS							No
(39) PROCLINIX SPORTS 99 BUSINESS PARK DRIVE ARMONK,NY10504	CONTRIBUTING EMPLOYERS							No
(40) PROMET PHYSICAL THERAPY PC 123-08 METROPOLITAN AVE KEW GARDENS,NY11415	CONTRIBUTING EMPLOYERS							No
(41) ROBERT HENRY ARCHITECTS 111 JOHN STREET 200 NEW YORK,NY10038	CONTRIBUTING EMPLOYERS							No
(42) RONNETTE RILEY ARCHITECT 350 5TH AVENUE 7401 NEW YORK,NY10118	CONTRIBUTING EMPLOYERS							No
(43) SACHEM DENTAL UNAVAILABLE NEW YORK,NY00000	CONTRIBUTING EMPLOYERS							No
(44) SHARK BYTE SYSTEMS 44 WALL STREET 12 NEW YORK,NY10005	CONTRIBUTING EMPLOYERS							No
(45) SHOP LLC UNAVAILABLE NEW YORK,NY00000	CONTRIBUTING EMPLOYERS							No
(46) STATEWIDE REALTY UNAVAILABLE NEW YORK,NY00000	CONTRIBUTING EMPLOYERS							No
(47) VALENCAMBO SUPERIOR SEAFOOD CORP 120 S MAIN STREET PORT CHESTER,NY10573	CONTRIBUTING EMPLOYERS							No
(48) WETTLING ARCHITECTS 270 LAFAYETTE STREET SUITE 400 NEW YORK,NY10012	CONTRIBUTING EMPLOYERS							No
(49) TRUESDALE CONSULTING 364 ADAMS STREET BEDFORD HILLS,NY10507	CONTRIBUTING EMPLOYERS							No
(50) WM CAPITAL PARTNERS LLC 500 5TH AVENUE NEW YORK,NY10110	CONTRIBUTING EMPLOYERS							No
(51) YOUR WIRELESS INC 198 GLEN COVE RD CARLE PLACE,NY11514	CONTRIBUTING EMPLOYERS							No
(52) AFI 30 UNDERCLIFF AVE ELMSFORD,NY10523	CONTRIBUTING EMPLOYERS							No
(53) AFLACK AGENCY 199 WATERS STREET NEW YORK,NY10038	CONTRIBUTING EMPLOYERS							No
(54) ALL COUNTY SEWER 7 GREENFIELD DRIVE WARWICK,NY10990	CONTRIBUTING EMPLOYERS							No
(55) ALOSIO MD 45 DECKER ROAD LAFYETTE,NJ07848	CONTRIBUTING EMPLOYERS							No
(56) AMISH DOSHI PC 268-18 79TH AVENUE FLURAL PARK,NY11004	CONTRIBUTING EMPLOYERS							No
(57) ANTUNES IRON WORKS 18 TROY LANE YONKERS,NY10701	CONTRIBUTING EMPLOYERS							No
(58) ARONWITZ PHD 120 EAST 86TH STREET 4A NEW YORK,NY10028	CONTRIBUTING EMPLOYERS							No
(59) BARKER CONSULTING 35 COURTLAND ROAD MAHOPAC,NY10541	CONTRIBUTING EMPLOYERS							No
(60) BARTRAIN 447 E BOSTON POST RD MAMARONECK,NY10543	CONTRIBUTING EMPLOYERS							No
(61) BD MCFARLAND & COMP 48 LACKAWANA TRAIL SUFFERN,NY10901	CONTRIBUTING EMPLOYERS							No
(62) BENCAR BUILDERS 240 EAST 86TH STREET NEW YORK,NY10028	CONTRIBUTING EMPLOYERS							No
(63) BUY RITE INSURANCE 85 N CENTRAL AVE ELMSFORD,NY10523	CONTRIBUTING EMPLOYERS							No
(64) BYRAM OCCUPATIONAL THEAPY SERVICES 8 HAMPTON PLACE KATONAH,NY10536	CONTRIBUTING EMPLOYERS							No
(65) CUNNINGHAM CHIROPRACTIC 57 PROSPECT ST RIDGEFIELD,CT06877	CONTRIBUTING EMPLOYERS							No
(66) DANIEL JAMES MULTIMEDIA 29 SHEEP HILL ROAD RIVERSIDE,CT06878	CONTRIBUTING EMPLOYERS							No
(67) DEDES REALTY 2039 BAY BLVD ORTELY BEACH,NJ08751	CONTRIBUTING EMPLOYERS							No
(68) DRAGER ART SALES 45 WEST 11TH STREET NEW YORK,NY10011	CONTRIBUTING EMPLOYERS							No
(69) EQUINOX FITNESS 300 EAST 33RD STREET NEW YORK,NY10016	CONTRIBUTING EMPLOYERS							No
(70) ERIK NATE EURO HOCKEY 18 PROMROSE AVE WEST WHITE PLAINS,NY10607	CONTRIBUTING EMPLOYERS							No
(71) EXECUDENT 100 SNAKE HILL ROAD WEST NYACK,NY10994	CONTRIBUTING EMPLOYERS							No
(72) FHA APRAISERS 28 LEWIS PLACE NEW YORK,NY10804	CONTRIBUTING EMPLOYERS							No
(73) FIRST COLONIAL GROUP 311 EAST 38TH STREET 17B NEW YORK,NY10016	CONTRIBUTING EMPLOYERS							No
(74) FOX & LEFKOWITZ 1400 OLD COUNTRY ROAD STE 108 WESTBURY,NY11590	CONTRIBUTING EMPLOYERS							No
(75) FRANCO ROOFING 159 RAMSEY AVE YONKERS,NY10701	CONTRIBUTING EMPLOYERS							No
(76) HARTSDALE PHARMACY 211 EAST HARTSDALE AVE HARTSDALE,NY10530	CONTRIBUTING EMPLOYERS							No
(77) INFINIY ADMINSTRATORS 22 DIRENENZO COURT STATEN ISLAND,NY10309	CONTRIBUTING EMPLOYERS							No
(78) JD SULLIVAN BUILDING CORP 14 GREENTREE ROAD YORKTOWN HEIGHTS,NY10598	CONTRIBUTING EMPLOYERS							No
(79) KALE DUNN PSYD 81 MEYERSVILLE ROAD CHATHAM,NJ07928	CONTRIBUTING EMPLOYERS							No
(80) KITKAT TRADING 28 LONDONDERRY LANE SOMERS,NY10589	CONTRIBUTING EMPLOYERS							No
(81) LAIZ MARCELLO MD 140 LOCKWOOD AVE SUITE 203 NEW ROCHELLE,NY10801	CONTRIBUTING EMPLOYERS							No
(82) LAPLACITA MARKET CORP 1352 KITCHAWAN ROAD OSSINING,NY10562	CONTRIBUTING EMPLOYERS							No
(83) LAW OFFICES OF KEVIN FAGA PC 300 KNOLLWOOD ROAD SUITE 301 WHITE PLAINS,NY10607	CONTRIBUTING EMPLOYERS							No
(84) M TEITELBAUM ASSOICIATES 175 WEST 79ST APT 6D NEW YORK,NY10024	CONTRIBUTING EMPLOYERS							No
(85) MORZILLO ENTERPRISES INC 220 CHESTNUT STREET APT 2G PORT CHESTER,NY10573	CONTRIBUTING EMPLOYERS							No
(86) RASPLER DEVELOPMENT 23 GODFREY ROAD WESTON,CT06883	CONTRIBUTING EMPLOYERS							No
(87) ROCK SHELTER CAPITAL 31 SHELTER ROCK ROAD WACCABUC,NY10597	CONTRIBUTING EMPLOYERS							No
(88) ROCKWOOD XLI 240 EAST 86TH STREET 16A NEW YORK,NY10028	CONTRIBUTING EMPLOYERS							No
(89) RONALD PRIMAS MD FACP M 501 E 87TH STREET APT SG NEW YORK,NY10128	CONTRIBUTING EMPLOYERS							No
(90) SCHUMANN DESIGNS 435 EAST 79TH STREET NEW YORK,NY10075	CONTRIBUTING EMPLOYERS							No
(91) SIONOLIFI LANDSCAPING 254 STERLING AVENUE YONKERS,NY10704	CONTRIBUTING EMPLOYERS							No
(92) SKS PRODUCTIONS 540 PROSPECT AVE APT 1 BROOKLYN,NY11215	CONTRIBUTING EMPLOYERS							No
(93) SORBY EQUIPMENT CORP 383 FORT WASHINGTON AVE HAWTHORNE,NY10532	CONTRIBUTING EMPLOYERS							No
(94) SPITHOYANNIS SALES 7024 THIRD AVE BROOKLYN,NY11209	CONTRIBUTING EMPLOYERS							No
(95) SUSAN FELE CONSULTING 142 BODINE STREET STATEN ISLAND,NY10310	CONTRIBUTING EMPLOYERS							No
(96) TWO BROTHERS CONTRACTING 7 CANDLEWOOD ROAD NEW YORK,NY10583	CONTRIBUTING EMPLOYERS							No
(97) VELOCITY WORLDWIDE 332 PROSPECT AVE 2ND FLOOR NEW YORK,NY11215	CONTRIBUTING EMPLOYERS							No
(98) WANG CONSULTING 338 EAST 67TH STREET APT 3 NEW YORK,NY10065	CONTRIBUTING EMPLOYERS							No
(99) WIN SHEFFIELD CONSULTING 400 EAST 59TH STREET WEST CARDELL,NY10022	CONTRIBUTING EMPLOYERS							No
(100) THINK ARCHITECTURE 101 VICTORY BLVD STATEN ISLAND,NY10301	CONTRIBUTING EMPLOYERS							No
(101) AMESETE CORP 325 5TH AVENUE STE 21A NEW YORK,NY11020	CONTRIBUTING EMPLOYERS							No
(102) BOOMAGERS 902 BROADWAY NEW YORK,NY10010	CONTRIBUTING EMPLOYERS							No
(103) CJ ANSELMI DC PC 915 BROADWAY STE 1106 NEW YORK,NY10010	CONTRIBUTING EMPLOYERS							No
(104) DEWITT TISHMAN ARCHITECTS LLP 770 LEXINGTON AVENUE 12TH FLOOR NEW YORK,NY10065	CONTRIBUTING EMPLOYERS							No
(105) DUKE PRODUCTS INC 7 ELM STREET MORRISTOWN,NJ07960	CONTRIBUTING EMPLOYERS							No
(106) FRANK PIZZURRO ARCHITECTS PC 307 7TH AVENUE STE 2204 NEW YORK,NY10001	CONTRIBUTING EMPLOYERS							No
(107) JAKLITSCH GARDNER ARCHITECTS 115 WEST 27TH STREET 9TH FLOOR NEW YORK,NY10001	CONTRIBUTING EMPLOYERS							No
(108) JERSEY SHORE POWERSPORTS 656 HIGHWAY 35 MIDDLETOWN,NJ07748	CONTRIBUTING EMPLOYERS							No
(109) JOHN J KNIGHT ASSOCIATES INC 1 KALIS WAY PARAMUS,NJ07652	CONTRIBUTING EMPLOYERS							No
(110) JORIPAN CORP 142 BROADWAY JERSEY CITY,NJ07306	CONTRIBUTING EMPLOYERS							No
(111) LIQUID WASTE HOLDINGS 226 PROSPECT POINT RD LAKE HOPATCONG,NJ07849	CONTRIBUTING EMPLOYERS							No
(112) M&J ELECTRICAL CONTRACTORS CORP 2324 STEINWART ST ASTORIA,NY11105	CONTRIBUTING EMPLOYERS							No
(113) MIDWEST AIR PRO 2054 N NEW ENGLAND AVE CHICAGO,IL60707	CONTRIBUTING EMPLOYERS							No
(114) OHLHAUSEN DUBOIS ARCHITECTS 14 EAST 4TH STREET STE 508 NEW YORK,NY10012	CONTRIBUTING EMPLOYERS							No
(115) RAMI GROSSMAN MD 1510 JERICHO TURNPIKE NEW HYDE,NY11040	CONTRIBUTING EMPLOYERS							No
(116) RELY ON SERVICES 151 HOLDEN BLVD STATEN ISLAND,NY10314	CONTRIBUTING EMPLOYERS							No
(117) PROOF CREATIVE APPAREL 68 JAY STREET STE 301 BROOKLYN,NY11201	CONTRIBUTING EMPLOYERS							No
(118) XYSTER CONSULTING INC 185 RIVER ROAD NYACK,NY10960	CONTRIBUTING EMPLOYERS							No
(119) ALL AMERICAN ENVIRONMENTAL SYSTEMS INC 303 BROADWAY VERPLANK,NY10596	CONTRIBUTING EMPLOYERS							No
(120) CARDIOVASCULAR SERVICES PC 970 N BROADWAY STE 210 YONKERS,NY10701	CONTRIBUTING EMPLOYERS							No
(121) CRICKETT CARE INC 144 S HIGHLAND AVE OSSINING,NY10562	CONTRIBUTING EMPLOYERS							No
(122) RUND 7442 VICTOR-PITTSFORD ROAD VICTOR,NY14564	CONTRIBUTING EMPLOYERS							No
(123) PAULIE'S INC DBA BUON AMICI RAIMO 238 CENTRAL AVENUE WHITE PLAINS,NY10606	CONTRIBUTING EMPLOYERS							No
(124) CASUCCI 414 BELL HALL BUFFALO,NY14260	CONTRIBUTING EMPLOYERS							No
(125) T&G BUSINESS SERVICES INC 55 SULGRAVE ROAD SCARESDALE,NY10523	CONTRIBUTING EMPLOYERS							No
(126) THERMODYNAMIX LLC 45 N LAWN AVE ELMSFORD,NY10523	CONTRIBUTING EMPLOYERS							No
(127) THRUWAY GLASS COMPANY OF WESTCHESTER INC 41 RELYEA PLACE NEW ROCHELLE,NY10801	CONTRIBUTING EMPLOYERS							No
(128) UNIKO MANUFACTURING INC 85 CRESCENT AVE NEW ROCHELLE,NY10801	CONTRIBUTING EMPLOYERS							No
(129) COMMERICAL MAINTENANCE ENTERPRISES 770 INDUSTRIAL DRIVE ELMHURST,IL60126	CONTRIBUTING EMPLOYERS							No

Schedule R (Form 990) 2019

Page 3

Part V

Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

b Gift, grant, or capital contribution to related organization(s) ............................

c Gift, grant, or capital contribution from related organization(s) ............................

d Loans or loan guarantees to or for related organization(s) ............................

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

k Lease of facilities, equipment, or other assets from related organization(s) ......................

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

m Performance of services or membership or fundraising solicitations by related organization(s) .................

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

o Sharing of paid employees with related organization(s) ............................

p Reimbursement paid to related organization(s) for expenses ............................

q Reimbursement paid by related organization(s) for expenses ............................

r Other transfer of cash or property to related organization(s) ............................

Yes

s Other transfer of cash or property from related organization(s) ............................

Yes

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved

Schedule R (Form 990) 2019

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2019

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R. (see instructions).

Return Reference	Explanation

Schedule R (Form 990) 2019

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: TO PROVIDE HEALTH BENEFITS
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	4
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	1
5	Total number of individuals employed in calendar year 2019 (Part V, line 2a) ......	5	0
6	Total number of volunteers (estimate if necessary) .............	6	0
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, line 39 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	0	0
9	Program service revenue (Part VIII, line 2g) .........	23,211,171	22,686,242
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	764	86
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	108,998	48,277
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	23,320,933	22,734,605
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	0
14	Benefits paid to or for members (Part IX, column (A), line 4).....	19,679,136	20,425,653
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	0	0
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	1,537,216	1,451,612
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	21,216,352	21,877,265
19	Revenue less expenses. Subtract line 18 from line 12.......	2,104,581	857,340
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	4,280,085	4,992,408
21	Total liabilities (Part X, line 26).............	187,693	42,676
22	Net assets or fund balances. Subtract line 21 from line 20.....	4,092,392	4,949,732

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )
	TO PROVIDE HEALTH CARE, DENTAL, AND PRESCRIPTION DRUG BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR ELIGIBLE DEPENDENTS.

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(D) Reportable compensation from the organization (W-2/1099-MISC)	(E) Reportable compensation from related organizations (W-2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and title
(1) PATRICK ADAMS...................................................................... TRUSTEE	5.00 ................. 0.03	X	0	0	0
(2) VIVIENNE BAILEY...................................................................... TRUSTEE	5.00 ................. 0.03	X	0	0	0
(3) ROBERT FIASCONE...................................................................... TRUSTEE	5.00 ................. 0.03	X	0	0	0
(4) TONINA COZZO...................................................................... TRUSTEE	5.00 ................. 0.03	X	0	0	0

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	0	0	0

(A) Name and business address	(B) Description of services	(C) Compensation
AEGIS ADMINISTRATIVE SERVICES 6970 W DIVERSEY CHICAGO,IL60707	THIRD PARTY ADMINISTRATOR	1,491,020




2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 1

1a	Federated campaigns..	1a
b	Membership dues..	1b
c	Fundraising events..	1c
d	Related organizations	1d
e	Government grants (contributions)	1e

f	All other contributions, gifts, grants, and similar amounts not included above	1f

g	Noncash contributions included in lines 1a - 1f:$	1g

h Total. Add lines 1a-1f.......

		Business Code
2a	EMPLOYER CONTRIBUTIONS	900099	20,207,563	20,207,563
b	STOP LOSS REFUNDS	900099	2,446,968	2,446,968
c	COBRA CONTRIBUTIONS	900099	31,711	31,711
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		22,686,242

3 Investment income (including dividends, interest, and othersimilar amounts) ......			86			86
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents			6a
b	Less: rental expenses			6b
c	Rental income or (loss)			6c
d	Net rental income or (loss).......
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory			7a
b	Less: cost or other basis and sales expenses			7b
c	Gain or (loss)			7c
d	Net gain or (loss).........
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	OTHER INCOME		900099	48,277	48,277
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			48,277
12	Total revenue. See instructions.....			22,734,605	22,734,519	0	86

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......	20,425,653
5	Compensation of current officers, directors, trustees, and key employees ...........
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........
7	Other salaries and wages........
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....
9	Other employee benefits .......
10	Payroll taxes ...........
11	Fees for services (non-employees):
a	Management ......	1,153,705
b	Legal .........	171,506
c	Accounting ...........	23,207
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	76,166
12	Advertising and promotion ....
13	Office expenses .......	5,885
14	Information technology ......
15	Royalties ..
16	Occupancy ...........
17	Travel ............
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....
20	Interest ...........
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..
23	Insurance ...	10,998
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	FEES MANDATED BY ACA	9,869
b	MISCELLANEOUS EXPENSE	241
c	BANK FEES	35
d
e	All other expenses
25	Total functional expenses. Add lines 1 through 24e	21,877,265
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........		3,386,188	1	3,424,040
2	Savings and temporary cash investments .........		123,178	2	123,265
3	Pledges and grants receivable, net ......			3
4	Accounts receivable, net .............		381,814	4	1,422,558
5	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
				5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
				6
7	Notes and loans receivable, net ...........			7
8	Inventories for sale or use ............			8
9	Prepaid expenses and deferred charges ......		382,448	9	22,545
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a
b	Less: accumulated depreciation	10b		10c
11	Investments—publicly traded securities .			11
12	Investments—other securities. See Part IV, line 11 .....			12
13	Investments—program-related. See Part IV, line 11 ..			13
14	Intangible assets ...............			14
15	Other assets. See Part IV, line 11 ...........		6,457	15	0
16	Total assets. Add lines 1 through 15 (must equal line 33)...		4,280,085	16	4,992,408

17	Accounts payable and accrued expenses .....	85,984	17	32,807
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	101,709	25	9,869
26	Total liabilities. Add lines 17 through 25..	187,693	26	42,676

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........		27
28	Net assets with donor restrictions ...........		28
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....	0	29	0
30	Paid-in or capital surplus, or land, building or equipment fund ...	0	30	0
31	Retained earnings, endowment, accumulated income, or other funds	4,092,392	31	4,949,732
32	Total net assets or fund balances ...........	4,092,392	32	4,949,732
33	Total liabilities and net assets/fund balances ........	4,280,085	33	4,992,408